CS109 - Surviving Sepsis League! Tackling the Sepsis Bundle on the MICU Gridiron
Primary Author: Akiko Kubo
Co-Author(s): Michelle Bolen
Institution: The University of Kansas Hospital, Kansas City, KS
Contact Email: akubo@kumc.edu
Purpose: The Surviving Sepsis Campaign introduced evidence-based guidelines for the management of sepsis. Due to the complexity and time sensitive nature of these interventions, our overall compliance with the Resuscitation Bundle and Management Bundle averaged 50% and 54% respectively in the Medical ICU. Through the "Surviving Sepsis League!" – a football themed contest – we were able to improve bundle compliance while promoting staff participation and enthusiasm towards meeting the sepsis guidelines.
Description: We were challenged with increasing adherence to a complex set of interventions that is also time sensitive, such as the Sepsis Bundles. Instead of the traditional methods of educating the staff, we created a football themed contest called the “Surviving Sepsis League!” to promote compliance. The ‘Rules’ are simple. A team consists of nurses and physicians assigned to care for that patient in the first 24 hour period following initiation of the severe sepsis/septic shock order set. Therefore, the team changes each time and there are as many teams as sepsis cases. Each team is scored on its ability to meet all 11 bundle items. A large bulletin board in the break room was transformed into a “gridiron” football field and teams are placed into brackets. Between 2 teams, the team meeting more bundle items advances to the next bracket. If the compliance number is tied, the team with the best resuscitation time advances towards the Sepsis Bowl! To help with the 6 hour and 24 hour countdown, the order set comes with a bright yellow sheet listing all 11 interventions. One can simply write-in the “due” times to be posted in a prominent location so every team member is aware of the timeline.
Evaluation/Outcomes: The campaign has been successful for several reasons. Contests are a fun way to learn. Our nurses are all very competitive and they do not want to let their teammates down. In the 1st 6 weeks, the nursing staff has become very knowledgeable about the 11 bundle items and the specific time requirements. After reviewing 30 ‘teams’ in 6 weeks, our current Resuscitation bundle compliance has increased from 50% to 100% with one hour as the time to beat. The Management bundle compliance has increased from 54% to 71%, although inconsistent glucose control continues to hinder us from achieving a higher rate. Our overall Sepsis Bundle compliance has improved from 25% to 71%!
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